10D2283873 CLIA NUMBER - PHYSICIANS SPECIALTIES, LLC

Laboratory Demographics

CLIA Number: 10D2283873

Facility Name: PHYSICIANS SPECIALTIES, LLC

Facility Address:
6702 W LINEBAUGH AVE
TAMPA, FL
ZIP 33625
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Facility Phone Number: 813 450-1790

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1285239269

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2283873
LAB Type	Physician Office
Facility Name	PHYSICIANS SPECIALTIES, LLC
Street	6702 W LINEBAUGH AVE
City	TAMPA
State	FL
ZIP	33625
Phone	813 450-1790
CertificateType	4
CertificateEffectiveDate	6/14/2023
CertificateExpirationDate	6/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024